A Case Series on Gossypiboma - Varied Clinical Presentations and Their Management

Unintentionally retained lap sponge mimicking an ovarian cyst two years after Caesarean section in a 37-year old patient: case report of a rare "never event" in Sudan

INTRODUCTION

This case report reports an unusual occurrence of gossypiboma, which refers to the accidental retention of surgical materials like sponges in the peritoneal cavity. The term is derived from "gossypium" (cotton) and "boma" (place of concealment). Its incidence varies with surgical type, posing diagnostic challenges due to nonspecific symptoms and equivocal imaging. Despite its rarity, gossypiboma poses significant risks, including intestinal obstruction and abscess formation.

CASE PRESENTATION

A 37-year-old woman with ten previous pregnancies and an emergent caesarean section presented with abdominal pain. Examination and ultrasound suggested an ovarian cyst. During surgery, a 10 × 10 cm gauze-filled mass adherent to the ovary and jejunum was found. Postoperatively, she recovered well with no complications. The patient was treated with intravenous fluids and antibiotics for five days post-surgery and recovered without any complications. She was discharged from the hospital five days after the procedure.

CONCLUSION

To the best of our knowledge, this is the first reported case of gossypiboma in Sudan in 2024, highlighting diagnostic challenges and the need for preventive protocols. Root cause analysis of accidents, enhanced training, application of advanced technologies and a collaborative culture in the operating room can prevent the occurrence of such incidents. This case underscores the importance of meticulous surgical protocols and continuous improvement in safety measures to prevent retained surgical items, ensuring patient safety and optimal outcomes.

A Pictorial Review of the Many Faces of Gossypiboma - Observations in 6 Cases

Gossypiboma or textiloma is the result of a foreign-body reaction to extraneous material, usually a surgical sponge that was accidentally retained within the body.

The diagnosis of a retained surgical sponge is often delayed due to its infrequent occurrence and protean appearances.

The purpose of this pictorial review is to define the common sonographic and CT features of gossypiboma. A retrospective review of sonographic and CT images of 6 surgically proven cases of retained surgical sponges was undertaken.

FOREIGN BODIES IN THE URINARY BLADDER - CASE SERIES

Foreign bodies get into the bladder by self insertion, migration or as a component of iatrogenic and penetrating injuries. Diagnosis and treatment pose great challenges to the urologist especially if they are radiolucent. A common pattern of presentation is with lower urinary tract symptoms. High index of suspicion is required in patient with lower urinary symptoms. We hereby report 5 cases of foreign bodies in the urinary bladder, 2 (40%) self inflicted, 2(40%) iatrogenic and 1(20%) due to migration of the object; as well as their successful management.

CONCLUSION

Foreign bodies in the urinary bladder still remain a great challenge to the urologist; removal of the foreign body without injury to the urinary bladder or the urethra gives good outcome.